Sunday, December 15, 2013

Single-Payer by Default?

Federal officials, insurers, and health providers say they are concerned about the confusion and possible chaos in the early days of January, when people try to use the new insurance coverage they have.

Robert Pear, “Errors Cut, Officials Say; Fixes Are Overstated, Insurers Report; New York Times, December 15, 2013

Is the following scenario plausible or possible?

Patients who have enrolled in the health exchanges, assuming they are covered, find they are not.

People whose health plans have been cancelled, discover they cannot afford new policies with higher premiums and astronomical deductibles, and find they are unable to find doctors to care for them.

Both of these sets of Americans get sick, go to a doctor, clinic, or hospital, who tell them they are either not covered, or their insurance reimbursement rates  are too low,   or there’s some error in, or they have no record of their belonging to any  plan,   or they  have been excluded  from insurer networks and cannot care for them.

Word Spreads

Word of patient  non-treatment,  non-acceptance,  and doctor exclusion  spreads to their friends,  relatives,  fellow workers, and to the new media. 

National outrage ensues. The public goes ballistic.  Angry citizens shout at government: What are you going to do about this?  It isn’t fair!  Someone is at fault!   You're the government! What are you going to do about it?

The government, in a panic, says to insurers:  Provide coverage to anyone who wants it.   We’ll cover your back, or any other part of your anatomy.  Forget about the back end of the exchanges.  That's behind us now.  Count on us for payment.  We’ll work out the details and the financial arrangements later.  Better late than never.  Later we should have the website fixed.   Relax your rules.  Forget those delays and deadlines.    Disregard that talk about policies being cancelled because they don’t comply with the letter of the law.  All we want is a smooth transition to ObamaCare.  We’re the government. We’ll take care of you.

And you insurers,  don’t worry about those profiteering hospitals and doctors.   We’ll take care of them later.  We’ll cut their rates,  reduce the number who can care for you, limit the services they can offer, even force them to accept you as a condition for a medical license or the license to run a hospital.

We will nationalize care by forcing insurers and providers to play by new national rules. Confusion and chaos will be our friends. A hard beginning to ObamaCare will have a happy ending. The hand that rocks the cradle from womb to tomb will finally rule the health care world. Competence under the old rules is no longer required.

Presto!  Voila!  We will have single-payer system  through a fault of our own – through government default!  

Tweet:   Confusion and chaos in January due to ObamaCare’s flawed website may help nationalize health plans and health care.

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